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Transient acantholytic dermatosis pathology

Authors: Dr Achala Liyanage, Dermatology Fellow, Waikato Hospital, Hamilton, New Zealand; Assoc Prof Patrick Emanuel, Dermatopathologist, Auckland, New Zealand. January 2015.

Table of contents

Transient acantholytic dermatosis or Grover disease generally affects elderly men, who often present with pruritic erythematous papules, erosions and vesicles predominantly on the upper torso.

Histology of transient acantholytic dermatosis

There are four histological patterns described in transient acantholytic dermatosis. More than one histological pattern may be present.

  • Darier-like pattern
  • Hailey–Hailey-like pattern
  • Pemphigus vulgaris-like pattern
  • Spongiotic pattern

Microscopically, there is clefting in the upper layers secondary to acantholysis. There is usually a superficial dermal infiltrate of lymphocytes and eosinophils are sometimes present. Eosinophilic spongiosis is common in early lesions.

Transient acantholytic dermatosis pathology

Image provided by Dr Duncan Lamont, Waikato Hospital

Special studies in Grover disease

Direct immunofluroscence is negative.

Differential diagnosis of Grover disease

Darier disease

Pemphigus vulgaris

Hailey-Hailey disease



  • Weedon’s Skin Pathology (Third edition, 2010). David Weedon

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